Suleiman Furmli, M.D., from the University of Toronto Faculty of Medicine, and colleagues describe three patients referred to the Intensive Dietary Management clinic in Toronto for insulin-dependent type 2 diabetes. At the initial consultation, all patients had been receiving various pharmacological therapies, including at least 70 units of insulin per day. After educational training, patients were instructed to follow a scheduled 24-hour fast three times per week over several months.

The researchers found that all three patients had complete discontinuation of insulin. Two of the patients discontinued all diabetic medications, while one discontinued three out of four medications after the fasting regimen. The minimum and maximum number of days to discontinuation of insulin was five and 18, respectively. For all patients, there was a general reduction in hemoglobin A1c levels during the course of the fast. None of the patients had symptomatic episodes of hypoglycemia. All patients had weight loss and reduction in waist circumference; fasting was well tolerated, and feedback was very positive.